On This Day … 20 April [2022]

People (Births)

  • 1745 – Philippe Pinel, French physician and psychiatrist (d. 1826).
  • 1915 – Joseph Wolpe, South African psychotherapist and physician (d. 1997).
  • 1920 – Frances Ames, South African neurologist, psychiatrist, and human rights activist (d. 2002).

Philippe Pinel

Philippe Pinel (20 April 1745 to 25 October 1826) was a French physician, precursor of psychiatry and incidentally a zoologist. He was instrumental in the development of a more humane psychological approach to the custody and care of psychiatric patients, referred to today as moral therapy. He worked for the abolition of the shackling of mental patients by chains and, more generally, for the humanisation of their treatment. He also made notable contributions to the classification of mental disorders and has been described by some as “the father of modern psychiatry”.

After the French Revolution, Dr. Pinel changed the way we look at the crazy (or “aliénés”, “alienated” in English) by claiming that they can be understood and cured. An 1809 description of a case that Pinel recorded in the second edition of his textbook on insanity is regarded by some as the earliest evidence for the existence of the form of mental disorder later known as dementia praecox or schizophrenia, although Emil Kraepelin is generally accredited with its first conceptualisation.

“Father of modern psychiatry”, he was credited with the first classification of mental illnesses. He had a great influence on psychiatry and the treatment of the alienated in Europe and the United States.

Joseph Wolpe

Joseph Wolpe (20 April 1915 to 04 December 1997) was a South African psychiatrist and one of the most influential figures in behaviour therapy.

Wolpe grew up in South Africa, attending Parktown Boys’ High School and obtaining his MD from the University of the Witwatersrand.

In 1956, Wolpe was awarded a Ford Fellowship and spent a year at Stanford University in the Centre for Behavioral Sciences, subsequently returning to South Africa but permanently moving to the United States in 1960 when he accepted a position at the University of Virginia.

In 1965, Wolpe accepted a position at Temple University.

One of the most influential experiences in Wolpe’s life was when he enlisted in the South African army as a medical officer. Wolpe was entrusted to treat soldiers who were diagnosed with what was then called “war neurosis” but today is known as post traumatic stress disorder. The mainstream treatment of the time for soldiers was based on psychoanalytic theory, and involved exploring the trauma while taking a hypnotic agent – so-called narcotherapy. It was believed that having the soldiers talk about their repressed experiences openly would effectively cure their neurosis. However, this was not the case. It was this lack of successful treatment outcomes that forced Wolpe, once a dedicated follower of Freud, to question psychoanalytic therapy and search for more effective treatment options. Wolpe is most well known for his reciprocal inhibition techniques, particularly systematic desensitisation, which revolutionised behavioural therapy. A Review of General Psychology survey, published in 2002, ranked Wolpe as the 53rd most cited psychologist of the 20th century, an impressive accomplishment accentuated by the fact that Wolpe was a psychiatrist.

Frances Ames

Frances Rix Ames (20 April 1920 to 11 November 2002) was a South African neurologist, psychiatrist, and human rights activist, best known for leading the medical ethics inquiry into the death of anti-apartheid activist Steve Biko, who died from medical neglect after being tortured in police custody. When the South African Medical and Dental Council (SAMDC) declined to discipline the chief district surgeon and his assistant who treated Biko, Ames and a group of five academics and physicians raised funds and fought an eight-year legal battle against the medical establishment. Ames risked her personal safety and academic career in her pursuit of justice, taking the dispute to the South African Supreme Court, where she eventually won the case in 1985.

Born in Pretoria and raised in poverty in Cape Town, Ames became the first woman to receive a Doctor of Medicine degree from the University of Cape Town in 1964. Ames studied the effects of cannabis on the brain and published several articles on the subject. Seeing the therapeutic benefits of cannabis on patients in her own hospital, she became an early proponent of legalization for medicinal use. She headed the neurology department at Groote Schuur Hospital before retiring in 1985, but continued to lecture at Valkenberg and Alexandra Hospital. After apartheid was dismantled in 1994, Ames testified at the Truth and Reconciliation Commission about her work on the “Biko doctors” medical ethics inquiry. In 1999, Nelson Mandela awarded Ames the Star of South Africa, the country’s highest civilian award, in recognition of her work on behalf of human rights.

Who was Frances Ames?

Introduction

Frances Rix Ames (20 April 1920 to 11 November 2002) was a South African neurologist, psychiatrist, and human rights activist, best known for leading the medical ethics inquiry into the death of anti-apartheid activist Steve Biko, who died from medical neglect after being tortured in police custody.

When the South African Medical and Dental Council (SAMDC) declined to discipline the chief district surgeon and his assistant who treated Biko, Ames and a group of five academics and physicians raised funds and fought an eight-year legal battle against the medical establishment. Ames risked her personal safety and academic career in her pursuit of justice, taking the dispute to the South African Supreme Court, where she eventually won the case in 1985.

Born in Pretoria and raised in poverty in Cape Town, Ames became the first woman to receive a Doctor of Medicine degree from the University of Cape Town in 1964. Ames studied the effects of cannabis on the brain and published several articles on the subject. Seeing the therapeutic benefits of cannabis on patients in her own hospital, she became an early proponent of legalization for medicinal use. She headed the neurology department at Groote Schuur Hospital before retiring in 1985, but continued to lecture at Valkenberg and Alexandra Hospital. After apartheid was dismantled in 1994, Ames testified at the Truth and Reconciliation Commission about her work on the “Biko doctors” medical ethics inquiry. In 1999, Nelson Mandela awarded Ames the Star of South Africa, the country’s highest civilian award, in recognition of her work on behalf of human rights.

Early Life

Ames was born at Voortrekkerhoogte in Pretoria, South Africa, on 20 April 1920, to Frank and Georgina Ames, the second of three daughters. Her mother, who was raised in a Boer concentration camp by Ames’ grandmother, a nurse in the Second Boer War, was also a nurse. Ames never knew her father, who left her mother alone to raise three daughters in poverty. With her mother unable to care for her family, Ames spent part of her childhood in a Catholic orphanage where she was stricken with typhoid fever. Her mother later rejoined the family and moved them to Cape Town, where Ames attended the Rustenburg School for Girls. She enrolled at the University of Cape Town (UCT) medical school where she received her MBChB degree in 1942.

Medical Career

In Cape Town, Ames interned at Groote Schuur Hospital; she also worked in the Transkei region as a general practitioner. She earned her MD degree in 1964 from UCT, the first woman to do so. Ames became head of the neurology department at Groote Schuur Hospital in 1976. She was made an associate professor in 1978. Ames retired in 1985, but continued to work part-time at both Valkenberg and Alexandra Hospital as a lecturer in the UCT Psychiatry and Mental Health departments. In 1997, UCT made Ames an associate professor emeritus of neurology; she received an honorary doctorate in medicine from UCT in 2001. According to Pat Sidley of the British Medical Journal, Ames “was never made a full professor, and believed that this was because she was a woman.”

Biko Affair

South African anti-apartheid activist Steve Biko, who had formerly studied medicine at the University of Natal Medical School, was detained by Port Elizabeth security police on 18 August 1977 and held for 20 days. Sometime between 06 and 07 September, Biko was beaten and tortured into a coma. According to allegations by Ames and others, surgeon Ivor Lang, along with chief district surgeon Benjamin Tucker, collaborated with the police and covered up the abuse, leading to Biko’s death from his injuries on 12 September. According to Benatar & Benatar 2012, “there were clear ethical breaches on the part of the doctors who were responsible” for Biko.

When the South African Medical and Dental Council (SAMDC) along with the support of the Medical Association of South Africa (MASA), declined to discipline the district surgeons in Biko’s death, two groups of physicians filed separate formal complaints with the SAMDC regarding the lack of professionalism shown by Biko’s doctors. Both cases made their way to the South African Supreme Court in an attempt to force the SAMDC to conduct a formal inquiry into the medical ethics of Lang and Tucker. One case was filed by Ames, along with Trefor Jenkins and Phillip Tobias of the University of the Witwatersrand; a second case was filed by Dumisani Mzana, Yosuf Veriava of Coronationville Hospital, and Tim Wilson of Alexandra Health Centre.

As Ames and the small group of physicians pursued an inquiry into members of their own profession, Ames was called a whistleblower. Her position at the university was threatened by her superiors and her colleagues asked her to drop the case. By pursuing the case against the Biko doctors, Ames received personal threats and risked her safety. Baldwin-Ragaven et al. note that the medical association “closed ranks in support of colleagues who colluded with the security police in the torture and death of detainees [and] also attempted to silence and discredit those doctors who stood up for human rights and who demanded disciplinary action against their colleagues.”

After eight years, Ames won the case in 1985 when the South African Supreme Court ruled in her favour. With Ames’ help, the case forced the medical regulatory body to reverse their decision. The two doctors who treated Biko were finally disciplined and major medical reforms followed. According to Benatar & Benatar 2012, the case “played an important role in sensitising the medical profession to medical ethical issues in South Africa.”

Cannabis Research

Ames studied the effects of cannabis in 1958, publishing her work in The British Journal of Psychiatry as “A clinical and metabolic study of acute intoxication with Cannabis sativa and its role in the model psychoses”. Her work is cited extensively throughout the cannabis literature. She opposed the War on Drugs and was a proponent of the therapeutic benefits of cannabis, particularly for people with multiple sclerosis (MS). Ames observed first-hand how cannabis (known as dagga in South Africa) relieved spasm in MS patients and helped paraplegics in the spinal injuries ward of her hospital. She continued to study the effects of cannabis in the 1990s, publishing several articles about cannabis-induced euphoria and the effects of cannabis on the brain.

Personal Life

Ames was married to editorial writer David Castle of the Cape Times and they had four sons. She was 47 years old when her husband died unexpectedly in 1967. After her husband’s death, Ames’s housekeeper Rosalina helped raise the family. Ames wrote about the experience in her memoir, Mothering in an Apartheid Society (2002).

Death

Ames struggled with leukaemia for some time. Before her death, she told an interviewer, “I shall go on until I drop.” She continued to work for UCT as a part-time lecturer at Valkenberg Hospital until six weeks before she died at home in Rondebosch on 11 November 2002. Representing UCT’s psychiatry department, Greg McCarthy gave the eulogy at the funeral. Ames was cremated, and according to her wishes, her ashes were combined with hemp seed and dispersed outside of Valkenberg Hospital where her memorial service was held.

Legacy

South African neurosurgeon Colin Froman referred to Ames as the “great and unorthodox protagonist for the medical use of marijuana many years before the current interest in its use as a therapeutic drug”. J.P. van Niekerk of the South African Medical Journal notes that “Frances Ames led by conviction and example” and history eventually justified her action in the Biko affair.

Ames’s work on the Biko affair led to major medical reforms in South Africa, including the disbanding and replacement of the old apartheid-era medical organisations which failed to uphold the medical standards of the profession. According to van Niekerk, “the most enduring lesson for South African medicine was the clarification of the roles of medical practitioners when there is a question of dual responsibilities. This is now embodied inter alia in the SAMA Code of Conduct and in legal interpretations of doctors’ responsibilities”.

Ames testified during the medical hearings at the Truth and Reconciliation Commission in 1997. Archbishop Desmond Tutu honoured Ames as “one of the handful of doctors who stood up to the apartheid regime and brought to book those doctors who had colluded with human rights abuse.” In acknowledgement of her work on behalf of human rights in South Africa, Nelson Mandela awarded Ames the Order of the Star of South Africa in 1999, the highest civilian award in the country.

On This Day … 11 November

People (Births)

  • 1743 – Carl Peter Thunberg, Swedish botanist, entomologist, and psychologist (d. 1828).
  • 1891 – Grunya Sukhareva, Ukrainian-Russian psychiatrist and university lecturer (d. 1981).

People (Deaths)

  • 2002 – Frances Ames, South African neurologist, psychiatrist, and human rights activist (b. 1920).

Carl Peter Thunberg

Carl Peter Thunberg, also known as Karl Peter von Thunberg, Carl Pehr Thunberg, or Carl Per Thunberg (11 November 1743 to 08 August 1828), was a Swedish naturalist and an “apostle” of Carl Linnaeus.

After studying under Linnaeus at Uppsala University, he spent seven years travelling in southern Africa and Asia, collecting and describing many plants and animals new to European science, and observing local cultures. He has been called “the father of South African botany”, “pioneer of Occidental Medicine in Japan”, and the “Japanese Linnaeus”.

Grunya Sukhareva

Grunya Efimovna Sukhareva (11 November 1891 to 26 April 1981) was a Soviet child psychiatrist.

She was the first to publish a detailed description of autistic symptoms in 1925. The original paper was in Russian and published in German a year later. Sula Wolff translated it in 1996 for the English-speaking world.

She initially used the term “schizoid psychopathy”, “schizoid” meaning “eccentric” at the time, but later replaced it with “autistic (pathological avoidant) psychopathy” to describe the clinical picture of autism. The article was created almost two decades before the case reports of Hans Asperger and Leo Kanner, which were published while Sukhareva’s pioneering work remained unnoticed. This is possibly because of various political and language barriers at the time. Her name was transliterated as “Ssucharewa” when her papers appeared in Germany, and the autism researcher Hans Asperger likely chose not to cite her work, due to his affiliation with the Nazi Party and her Jewish heritage.

Frances Ames

Frances Rix Ames (20 April 1920 to 11 November 2002) was a South African neurologist, psychiatrist, and human rights activist, best known for leading the medical ethics inquiry into the death of anti-apartheid activist Steve Biko, who died from medical neglect after being tortured in police custody.

When the South African Medical and Dental Council (SAMDC) declined to discipline the chief district surgeon and his assistant who treated Biko, Ames and a group of five academics and physicians raised funds and fought an eight-year legal battle against the medical establishment. Ames risked her personal safety and academic career in her pursuit of justice, taking the dispute to the South African Supreme Court, where she eventually won the case in 1985.

Born in Pretoria and raised in poverty in Cape Town, Ames became the first woman to receive a Doctor of Medicine degree from the University of Cape Town in 1964. Ames studied the effects of cannabis on the brain and published several articles on the subject. Seeing the therapeutic benefits of cannabis on patients in her own hospital, she became an early proponent of legalisation for medicinal use. She headed the neurology department at Groote Schuur Hospital before retiring in 1985, but continued to lecture at Valkenberg and Alexandra Hospital. After apartheid was dismantled in 1994, Ames testified at the Truth and Reconciliation Commission about her work on the “Biko doctors” medical ethics inquiry. In 1999, Nelson Mandela awarded Ames the Star of South Africa, the country’s highest civilian award, in recognition of her work on behalf of human rights.

On This Day … 20 April

People (Births)

  • 1745 – Philippe Pinel, French physician and psychiatrist (d. 1826).
  • 1915 – Joseph Wolpe, South African psychotherapist and physician (d. 1997).
  • 1920 – Frances Ames, South African neurologist, psychiatrist, and human rights activist (d. 2002).

Philippe Pinel

Philippe Pinel (20 April 1745 to 25 October 1826) was a French physician who was instrumental in the development of a more humane psychological approach to the custody and care of psychiatric patients, referred to today as moral therapy. He also made notable contributions to the classification of mental disorders and has been described by some as “the father of modern psychiatry”.

An 1809 description of a case that Pinel recorded in the second edition of his textbook on insanity is regarded by some as the earliest evidence for the existence of the form of mental disorder later known as dementia praecox or schizophrenia, although Emil Kraepelin is generally accredited with its first conceptualisation.

Joseph Wolpe

Joseph Wolpe (20 April 1915 to 04 December 1997 in Los Angeles) was a South African psychiatrist and one of the most influential figures in behaviour therapy.

Wolpe grew up in South Africa, attending Parktown Boys’ High School and obtaining his MD from the University of the Witwatersrand.

In 1956 Wolpe was awarded a Ford Fellowship and spent a year at Stanford University in the Center for Behavioral Sciences, subsequently returning to South Africa but permanently moving to the United States in 1960 when he accepted a position at the University of Virginia.

In 1965 Wolpe accepted a position at Temple University.

One of the most influential experiences in Wolpe’s life was when he enlisted in the South African army as a medical officer. Wolpe was entrusted to treat soldiers who were diagnosed with what was then called “war neurosis” but today is known as post traumatic stress disorder. The mainstream treatment of the time for soldiers was based on psychoanalytic theory, and involved exploring the trauma while taking a hypnotic agent – so-called narcotherapy. It was believed that having the soldiers talk about their repressed experiences openly would effectively cure their neurosis. However, this was not the case. It was this lack of successful treatment outcomes that forced Wolpe, once a dedicated follower of Freud, to question psychoanalytic therapy and search for more effective treatment options. Wolpe is most well known for his reciprocal inhibition techniques, particularly systematic desensitisation, which revolutionised behavioural therapy.

A Review of General Psychology survey, published in 2002, ranked Wolpe as the 53rd most cited psychologist of the 20th century, an impressive accomplishment accentuated by the fact that Wolpe was a psychiatrist.

Frances Ames

Frances Rix Ames (20 April 1920 to 11 November 2002) was a South African neurologist, psychiatrist, and human rights activist, best known for leading the medical ethics inquiry into the death of anti-apartheid activist Steve Biko, who died from medical neglect after being tortured in police custody. When the South African Medical and Dental Council (SAMDC) declined to discipline the chief district surgeon and his assistant who treated Biko, Ames and a group of five academics and physicians raised funds and fought an eight-year legal battle against the medical establishment. Ames risked her personal safety and academic career in her pursuit of justice, taking the dispute to the South African Supreme Court, where she eventually won the case in 1985.

Born in Pretoria and raised in poverty in Cape Town, Ames became the first woman to receive a Doctor of Medicine degree from the University of Cape Town in 1964. Ames studied the effects of cannabis on the brain and published several articles on the subject. Seeing the therapeutic benefits of cannabis on patients in her own hospital, she became an early proponent of legalisation for medicinal use. She headed the neurology department at Groote Schuur Hospital before retiring in 1985, but continued to lecture at Valkenberg and Alexandra Hospital. After apartheid was dismantled in 1994, Ames testified at the Truth and Reconciliation Commission about her work on the “Biko doctors” medical ethics inquiry. In 1999, Nelson Mandela awarded Ames the Star of South Africa, the country’s highest civilian award, in recognition of her work on behalf of human rights.